Active NPI
Jeremy Kobulnik, M.D.
- Cardiovascular Disease Physician
- Boston, MA
National Provider Identifier
1013342518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 257277
- Practice address
- 732 Harrison Ave
Preston, 3Rd Floor
Boston, MA 02118-2309 - Phone
- (617) 638-7490
- Fax
- (617) 414-8742
- NPI assigned
- Sep 4, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 257277 | MA | Primary |
| Internal Medicine Physician | 207R00000X | 257277 | MA |
Addresses
Primary practice location
732 Harrison Ave
Preston, 3Rd Floor
Boston, MA 02118-2309
Mailing address
720 Harrison Ave
Dob 503
Boston, MA 02118-2371
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400803200000",
"number": "1013342518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 HARRISON AVE",
"address_2": "DOB 503",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "732 HARRISON AVE",
"address_2": "PRESTON, 3RD FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182309",
"telephone_number": "617-638-7490",
"fax_number": "617-414-8742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOBULNIK",
"first_name": "JEREMY",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-04",
"last_updated": "2014-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MA",
"license": "257277",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "257277",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.